Certificate Of Judge

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DEFENSE OF INDIGENTS ACT
FORM NO. 3
CERTIFICATE OF JUDGE
I hereby certify that the above-named defendant has been fully informed in open
Court of the charges against him and of his right to have counsel appointed by the Court
to represent him in this case; that he has elected in open Court to be tried in this case
without the appointment of counsel; and that he has executed the above waiver in my
presence after its meaning and effect have been fully explained to him.
This ____ day of _______________ , _____
____________________________________
Judge
CERTIFICATE OF JUDGE
I hereby certify that the above-named defendant has been fully informed in open
Court of the charges against him and of his right to have counsel appointed by the Court
to represent him in this case; that he has elected in open Court to be tried in this case
without the appointment of counsel and that he has refused to sign a waiver.
This ____ day of _______________ , _____
____________________________________
Judge

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